Global Health

Area leads

Dr Natalie Carvalho, Dr Angela Devine

The Health Economics Unit works on a broad range of research focused on important global health problems. We work in collaboration with the Nossal Institute, Murdoch Children’s Research Institute (MCRI), WEHI, Burnet Institute, Mahidol-Oxford Tropical Medicine Research Unit (MORU), Fiji Ministry of Health and Medical Services (MOHMS), UNICEF, London School of Hygiene and Tropical Medicine (LSHTM), Universitas Gadjah Mada Yogyakarta Indonesia (UGM) and our work is funded by NHMRC, Department of Foreign Affairs and Trade, Asian Development Bank, FIND, and MMV. Many of our projects aim to improve practices and training for economic evaluation, quality of life assessment, and data collection practices in LMICs. Current research initiatives include contributing to clinical and policy guidelines, the development of online tools to address policy decisions, and methods for valuating productivity losses in LMICs.

Related research staff:

Prof Kim Dalziel, A/Prof Ilias Goranitis, Dr Tianxin Pan, Mr Patrick Abraham

Projects listing

The E-MOTIVE trial evaluates the Early detection of Postpartum Haemorrhage and treatment using the WHO MOTIVE 'first response' bundle. This is a cluster randomised trial with health economic analysis and mixed methods evaluation conducted across 80 secondary level health facilities, across 5 low-and-middle-income countries (LMICs): Kenya, Tanzania, Nigeria, South Africa and Sri Lanka.  A/Prof Goranitis supports the economic evaluation. More info about the E-MOTIVE trial can be found here.

The AIMS trial was a multinational randomised, double-blind, placebo-controlled trial that evaluated the clinical effectiveness and cost-effectiveness of antibiotic prophylaxis during the surgical management of miscarriage across 13 hospitals in Malawi, Pakistan, Tanzania, and Uganda.  The clinical and health economics findings published in The New England Journal of Medicine and the Lancet Global Health respectively are now informing Government policy and international guidelines.

Evaluation of inhaled oxytocin for prevention of postpartum haemorrhage: In collaboration with the Nossal Institute for Global Health and Monash Institute of Pharmaceutical Sciences, this project modelled the cost-effectiveness of a heat-stable, non-injectable inhaled oxytocin product, for the prevention of postpartum haemorrhage in two high burden settings, Bangladesh and Ethiopia. Findings were recently published in BMC Medicine.

Online tools for economic evaluation: Online versions of cost-effectiveness models are increasingly being used to engage with the research community and communicate uncertainty in model parameters. Available online tools for vivax malara can be found here, here, and here. We are working to ensure that the development of online tools addresses the relevant information needs and policy decisions.

Selected Publications

Devine, A., Howes, R.E., Price, D.J., Moore, K.A., Ley, B., Simpson, J.A., Dittrich, S., Price, R.N. 2020. Cost-effectiveness analysis of sex-stratified Plasmodium vivax treatment strategies using available G6PD diagnostics to accelerate access to radical cure. Am J Trop Med Hyg, 103(1), pp.394-403. doi: 10.4269/ajtmh.19-0943.

Carvalho N, Hoque ME, Oliver VL, Byrne A, Kermode M, Lambert P, McIntosh MP, Morgan A. Cost-effectiveness of inhaled oxytocin for prevention of postpartum haemorrhage: A modelling study applied to two high burden settings. BMC Medicine 2020; 18(201). doi.org/10.1186/s12916-020-01658-y.

Lissauer, D., Wilson, A., Hewitt, C.A., Middleton, L., Bishop, J.R., Daniels, J., Merriel, A., Weeks, A., Mhango, C., Mataya, R., Taulo, F. […] Goranitis, I. et al., 2019. A randomized trial of prophylactic antibiotics for miscarriage surgery. New England Journal of Medicine, 380(11), pp.1012-1021.

Goranitis, I., Lissauer, D.M., Coomarasamy, A., Wilson, A., Daniels, J., Middleton, L., Bishop, J., Hewitt, C.A., Weeks, A.D., Mhango, C. and Mataya, R., 2019. Antibiotic prophylaxis in the surgical management of miscarriage in low-income countries: a cost-effectiveness analysis of the AIMS trial. The Lancet Global Health, 7(9), pp.e1280-e1286.

Devine, A, Pasaribu, AP, Teferi, T, Pham, HT, Awab, GR, Contantia, F, Nguyen, TN, Ngo, VT, Tran, H, Hailu, A, Gilchrist, K, Green, JA, Koh, GCKW, Thriemer, K, Taylor, WR, Day, NPJ, Price, RN, Lubell, Y. 2019. Economic costs of vivax malaria episodes: A multi-country comparative analysis using primary trial data. WHO Bulletin, 97, pp.828-836. doi: 10.2471/blt.18.226688

Carvalho N, Jit M, Cox S, Yoong J, Hutubessy R. 2018. Capturing budget impact considerations within economic evaluations: a systematic review of economic evaluations of rotavirus vaccine in low- and middle-income countries and a proposed assessment framework. Pharmacoeconomics 36(1): 79-90.

Eva G, Gold J, Makins A, Bright S, Dean K, Tunnacliffe E-A, Fatima P, Yesmin A, Muganyizi P, Kimario GF, Dalziel K. Economic Evaluation of Provision of Postpartum Intrauterine Device Services in Bangladesh and Tanzania. Global Health: Science and Practice March 2021, 9(1):107-122.

Pan, T., Mercer, S.W., Zhao, Y. et al. The association between mental-physical multimorbidity and disability, work productivity, and social participation in China: a panel data analysis. BMC Public Health 21, 376 (2021). https://doi.org/10.1186/s12889-021-10414-7